Home Monitors Don't Appear to Predict SIDS
For that reason, he says, even the extreme events do not appear
to predict which babies will succumb to SIDS. "These extreme events may
represent vulnerability for some later problems, but they are unlikely to be
the immediate precursor to SIDS," he tells WebMD. "If they did, you
would expect a lot more kids with SIDS [immediately following the extreme
In an editorial accompanying the report, Alan H. Jobe, MD, PhD,
notes that approximately 20,000 preterm infants are sent home every year with
monitors at a cost of approximately $24 million per year. He says that although
the study was not designed to test the usefulness of home monitors to prevent
SIDS, the study results in more doubt than ever before on such a practice.
Jobe is with the division of pulmonary biology at Children's
Hospital Medical Center in Cincinnati.
Pediatrician Michael Malloy, MD, says the results come as no
surprise. "They confirm previous research showing that monitoring is not
the way for us to go about preventing SIDS," Malloy tells WebMD.
He is professor of pediatrics at the University of Texas
Medical Branch in Galveston and a member of the American Academy of Pediatrics'
(AAP) Task Force on Infant Positioning and SIDS.
So what can parents do to prevent SIDS?
Malloy suggests the best prevention is proper bedding and, most
important of all, placing infants on their back when they sleep. "At this
point, it appears we have had some impact [on SIDS] with the Back-to-Sleep
Campaign," Malloy tells WebMD.
Back-to-Sleep is the AAP's nationwide campaign encouraging
parents to place their babies on their backs, and not to let infants sleep face
down, in the so-called "prone" position.
A policy statement released last year by the AAP's Task Force
on Infant Positioning and SIDS stated: "There is no evidence that home
monitoring with such monitors decreases the incidence of SIDS. Furthermore,
there is no evidence that infants at increased risk of SIDS can be identified
by in-hospital respiratory or cardiac monitoring."
That report included a number of recommendations for how to
prevent SIDS. Among them are the following:
- Infants should be placed for sleep in a nonprone position. While side
sleeping is not as safe as sleeping on the back, it is safer than sleeping
face-down. If the side position is used, caretakers should be advised to bring
the arm that is underneath the side-sleeping infant forward, to lessen the
likelihood of the infant rolling to the prone position.
- Parents should use a crib that conforms to the safety standards of the
Consumer Product Safety Commission.
- Parents should not place infants on waterbeds, sofas, soft mattresses, or
other soft surfaces. Also, loose bedding, such as blankets and sheets, may be
hazardous. If blankets are to be used, they should be tucked in around the crib
mattress so the infant's face is less likely to become covered by bedding.
- Bed sharing or co-sleeping may be hazardous under certain conditions. As an
alternative to bed sharing, parents might consider placing the infant's crib
near their bed to allow for more convenient breastfeeding and parent contact.
Parents who choose to bed share with their infant should not smoke or use
substances, such as alcohol or drugs, that may impair arousal.
- Overheating should be avoided. The infant should be lightly clothed for
sleep, and the bedroom temperature should be kept comfortable for a lightly